Endoscopic Rectus Abdominis and Prepubic Aponeurosis Repairs
Review of the English orthopaedic literature reveals no prior report of endoscopic repair of rectus abdominis tears and/or prepubic aponeurosis detachment. This technical report describes endoscopic reattachment of an avulsed prepubic aponeurosis and endoscopic repair of a vertical rectus abdominis tear immediately after endoscopic pubic symphysectomy for coexistent recalcitrant osteitis pubis as a single-stage outpatient surgery. Endoscopic rectus abdominis repair and prepubic aponeurosis repair are feasible surgeries that complement endoscopic pubic symphysectomy for patients with concurrent osteitis pubis and expand the less invasive options for patients with athletic pubalgia.

Osteitis pubis is a form of athletic pubalgia, and a recent study found a high prevalence in professional football players. It is associated with femoroacetabular impingement and may be caused by transfer stress from constrained range of motion in one or both hips. Endoscopic pubic symphysectomy has been found to be a safe and promising, less-invasive option to open pubic symphysis curettage.

Athletic pubalgia may also involve tears of the adductor and/or rectus abdominis tendons. Although open repair has been done, to our knowledge there is no previously published case of endoscopic repairs of the rectus tendon and the prepubic aponeurosis. The purpose of this technical report is to describe the endoscopic techniques used to perform endoscopic rectus abdominis and prepubic aponeurosis repairs after concurrent endoscopic pubic symphysectomy.